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Renton Children's DentistryDental Care for Infants, Children and AdolescentsPatient Forms

Dr. Shahram Ghafghazi, D.D.S. Board Certified Pediatric Dentist

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Health History (front)††

Health history (back)†††††††††††† † ††††††††††

Notice of Privacy††††††† ††††††††††††

Patient Registration†† ††††††††††††

Financial Agreement†† ††††††††††††

No Show Policy††††††††††† ††††††††††† ††††††††††† ††††††††††††